Figure 2 from Prostate Cancer Diagnosis Rates among Insured Men with and without HIV in South Africa: A Cohort Study

Graph illustrating structural assumptions regarding factors potentially confounding (red nodes) or mediating (blue nodes) the effect of HIV on incident prostate cancer diagnosis. Age, population group, STIs, and other unmeasured factors are assumed to be related with both HIV status and prostate cancer diagnosis and may, therefore, confound the effect of HIV on the risk of incident prostate cancer diagnosis. PSA testing, prostate biopsies, and prostatitis are assumed to be related with HIV status and to affect prostate cancer diagnosis rates and may, thus, serve as mediators. The dashed (yellow) lines indicate influences where the direction is unknown. The (orange) arrow represents the effect of HIV on incident prostate cancer diagnosis, taking into account confounders and mediators. This effect is interpreted as the possible biological effect of HIV on the risk of a prostate cancer diagnosis.